Association of Coronary Artery Atherosclerosis With Brain White Matter Hyperintensity.
Association of Coronary Artery Atherosclerosis With Brain White Matter Hyperintensity.
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DOI：
10.1161/strokeaha.120.032674
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发表时间：
2021-08
期刊：
影响因子：
8.3
通讯作者：
Nyquist P
中科院分区：
文献类型：
--
作者：
Johansen MC;Gottesman RF;Kral BG;Vaidya D;Yanek LR;Becker LC;Becker DM;Nyquist P
我们的目标是，在健康的高危成人中，确定亚临床冠状动脉疾病(CAD)与白质高强度(WMH)体积和位置之间的关系，而不是动脉粥样硬化的危险因素。本文分析了782例60岁早发性冠心病患者的无症状一级亲属，这些患者来自动脉粥样硬化危险基因研究(GeneSTAR)，同时进行了冠状动脉CTA(C-CTA)和脑MRI检查。多水平混合效应线性回归模型考虑了家庭结构，评估了WMH总体积和三个区域(深白质(DWMH)、脑室周围(PVWMH)或交界区(CUF))与冠心病标志物的关系。为总的WMH、DWMH、PVWMH和袖带容量建立了单独的模型，每个模型都作为因变量，跨越C-CTA变量，并对协变量进行了调整。平均年龄为51岁±10岁，女性占58%，非裔美国人占39%。有冠状动脉斑块的受试者的WMH体积比无斑块的受试者大52%(95%可信区间0.24-0.59)。冠状动脉斑块体积每增加1%，WMH总体积增加0.07%(95%可信区间0.04~0.10)。冠状动脉总斑块体积每增加1个百分点，与冠脉斑块体积增加5.03%(95%CI 4.67~5.38)、5.10%PVWMH体积增大(95%CI 4.72~5.48)和2.74%袖带体积(95%CI 2.38~3.09)相关，当比较DWMH与PVWMH(P-交互作用0.001)或袖带(P-交互作用&t；0.001)时，这种相关性存在差异。在健康的高危个体中，冠状动脉斑块的存在和体积与较大的WMH体积相关，其中PVWMH的相关性最强。在高危家庭中的这些发现表明，除了传统的危险因素外，两种不同的血管床上存在疾病关系，可能是由于遗传易感性。
We aim to determine, in healthy high-risk adults, the association between subclinical coronary artery disease (CAD) and white matter hyperintensity (WMH) volume and location, independent of atherosclerotic risk factors. 782 asymptomatic first-degree relatives of index cases with early-onset CAD (<60 years old) from Genetic Study of Atherosclerosis Risk (GeneSTAR) with contemporaneous coronary CTA (C-CTA) and brain MRI were analyzed. Multilevel mixed-effects linear regression models, accounting for family structure, evaluated the association of total WMH volume, and three regions (deep white matter (DWMH), periventricular (PVWMH) or borderzone (cuff)), with markers of CAD. Separate models were created for total WMH, DWMH, PVWMH and cuff volumes, each, as dependent variables, across C-CTA variables, adjusted for covariates. Mean age was 51years±10, with 58% female and 39% African-American. Participants with any coronary plaque had 52% larger WMH volumes than those without plaque (95%CI 0.24–0.59). Per 1% greater coronary plaque volume, total WMH volumes were 0.07% larger (95%CI 0.04–0.10). Every 1% higher total coronary plaque volume was associated with 5.03% larger DWMH volume (95%CI 4.67–5.38), 5.10% PVWMH larger volume (95%CI 4.72–5.48) and 2.74% larger cuff volume (95%CI 2.38–3.09) with differences in this association when comparing DWMH to PVWMH (P-interaction 0.001) or cuff (P-interaction <0.001) respectively. In healthy, high-risk individuals, the presence and volume of coronary artery plaque are associated with larger WMH volumes, appearing strongest for PVWMH. These findings in high-risk families suggest a disease relationship in two different vascular beds, beyond traditional risk factors, possibly due to genetic predisposition.